Contrast-enhanced ultrasonography detects carotid artery inflammation in Takayasu arteritis

Follow-up monitoring of the carotid artery with contrast-enhanced ultrasonography (CEUS) identifies response or relapse in most patients with Takayasu arteritis (TAK), reports a study.

A team of investigators assessed TAK patients who underwent carotid CEUS at least twice, with a follow-up duration of ≥12 months between 2017 and 2020 at Xijing Hospital in China. They explained how CEUS interpretation changed and recorded the state of remission (ie, bilateral CEUS visual grades 1) or relapse as determined by imaging.

One hundred six patients with TAK and 425 CEUS visits were assessed in this study, with a median follow-up of 25 months. Of the patients, 76 (71.7 percent) had active disease as determined by CEUS and 30 (28.3 percent) had inactive disease at baseline.

The CEUS vascularization grade significantly correlated with the Kerr criteria (r, 0.532; p<0.001), erythrocyte sedimentation rate (p<0.001), and C-reactive protein level (p<0.001).

On midterm assessment (median 13 months), 29 of the 76 CEUS-active patients (38.2 percent) achieved complete response, 34 (44.7 percent) showed partial response, and 13 (17.1 percent) had no response. The total number of responders at the last visit was 78 out of 94 (83.0 percent).

Twenty-eight out of 57 patients (49.1 percent) had CEUS relapse, with a median of 16 months. The Kaplan-Meier curve showed a lower remission rate when evaluated by the CEUS-combined method (median 22 months) than that of the clinical-only assessment (median 11 months; p0<.0001).

“CEUS is an effective technique for detecting carotid artery inflammation in patients with TAK,” the investigators said.